The Bilirubin, Albumin, Lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3), AFP, and DCP Score (BALAD score), developed by Toyoda et al. in 2006, aims to provide a straightforward and unbiased staging system devoid of imaging, pathological, or clinical evaluations. Derived from a study of 2600 HCC patients across five Japanese institutions, the score employs three tumor markers (AFP-L3 > 15%, AFP > 400 ng/dL, DCP > 100 mAU/mL) and two serum markers (bilirubin and albumin) reflective of tumor progression and liver functional reserve, respectively. Patients are categorized into six groups based on these factors. Survival curves based on BALAD scores show uniform distribution, with comparable discriminative ability to CLIP and JIS scores. However, global routine clinical adoption may be hindered by the challenge of measuring AFP-L3 and DCP values.